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Elexis

Elexis: tapering fluoxetine / Prozac - did I come off too fast?

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scallywag

The duration of a reinstatement is about 10-14 days, depending on the drug:  3-5 days to reach steady state and then 7-10 days to give your CNS time to adjust.

 

I'm glad the PGA is becoming less intense for you over time.

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Elexis

Updated reinstatement diary:

 

6th August

1.30: PGAD = 2

3pm: PGAD = 7

7pm: PGAD = 4

11pm: PGAD = 7

 

7th August

12pm:  PGAD = 1

4pm: PGAD = 1

7pm: PGAD = 7 (after sitting for 2-3 hrs)

9pm: PGAD = 4

12am: PGAD = 1

 

8th August

Can't recall but very low all day, no more than a 4.

 

9th August

2pm: PGAD = 1

4pm: PGAD = 4

7pm: PGAD = 6

10pm: PGAD = 5

 

10th August

2pm: PGAD = 2

3pm: PGAD = 6

7pm: PGAD = 4

8pm: PGAD = 7

11pm: PGAD = 3

 

11th August

2pm: PGAD = 1

5pm: PGAD = 4

7pm: PGAD = 6

8pm: PGAD = 4

11pm: PGAD = 3

 

12th August

2pm: PGAD = 1

3pm: PGAD = 4

4pm: PGAD = 7 (after sitting on hard seat)

 

 

It's a lot of data but I think it looks like the reinstatement sure hasn't made anything worse, I think overall the numbers are better than they were before. What do you think? What would be a good next step?

 

Thanks :)

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scallywag

Well you're at about 2 weeks after reinstating and it appears that your symptoms are settling. I suspect this settling will continue if you hold at 1 mg.  In your shoes, I'd be curious to see what might happen with a consistent daily dose for 2-3 months.

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Elexis

Cool, I'm up for doing that :) I should have noted in my last post that I've been avoiding sitting on hard seats as much as possible, trying to give this the best chance for recovery. Should I continue keeping symptom diaries?

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ChessieCat

Hi Elexis,

 

It's a good idea to keep notes on paper of what symptoms improve or worsen.  No need to post them here at the moment unless you want to keep a record in your topic).  That way if issues arise down the track you will be able to provide the information here so that it can be assessed and suggestions offered.  It can be very difficult several weeks later to try and remember what has gone on.

 

You may still have symptoms come and go but this is to be expected.  Please read this Windows and Waves Pattern of Stabilization.

 

You might find this helpful:  Claire Weekes' Method of Recovering from a Sensitized Nervous System

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Elexis

Hi,

thanks for the links. I'm wondering about how to know whether the reinstatement dose is 'enough'? Like should I expect a significant improvement over the next couple of weeks? Is upping the dose generally risky?

 

Sorry for asking obvious questions - I tried reading the thread about reinstatement but due to an eye condition flare up I can't do much reading right now without pain. :(

 

Thanks very much

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scallywag

Elexis, your symptoms are a sign that your CNS (central nervous system) is sensitized. Given that they (the symptoms) have improved somewhat with the reinstatement, the safest route is to continue to hold at a dose rather than increasing the dose.

3KIS: Keep it slow. Keep it simple. Keep it stable.

 

What is prompting your question about updosing?

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Elexis

Just wondering if it would make the symptoms go away better or faster. Like if 1mg causes 10% improvement then would 2mg cause 20% improvement? I suspect it's not that simple though & I may be asking a silly question. I've printed out the post you linked to read slowly as eyes allow :)

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scallywag

Increasing risks further destabilizing your CNS.  Too bad dose response isn't linear. ;) Unfortunately the only way to find out if it helps or makes things worse is to try it. If symptoms are tolerable, it's best to hold rather than updose.

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Elexis

Ah, I see, that makes sense. I'll keep going with the 1mg then, will keep a symptom diary as when my symptoms get worse it feels like they're totally intolerable but, from previous diaries, that usually only lasts a few hours (though it sure doesn't feel like that at the time!). Sounds like updosing is only worth the risk if things are pretty bad.

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AliG

Elexis. You could perhaps try 2 mg and see how it goes. There is a risk.that it could be destabilizing. I would hold where you are on  1mg.

As always though It is up to you.

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Elexis

Thanks for the advice guys, think I will stick to 1mg unless things deteriorate for some reason.

 

Quick query - was reading the thread about how to keep the CNS stable (not adding new supplements, lifestyle adjustments etc.) just wondering, do paracetemol and ibuprofen count as drugs that could destabilise CNS? I take one or both of them pretty much everyday before bed for chronic pain (have noticed they sometimes help the PGAD too). Do I have to be consistant with when I take them / how much I take in the same way I would with an antidepressant to avoid further destabilisation?

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ChessieCat

Hi Elexis,

 

Here is a link: Painkillers in withdrawal: Aspirin, ibuprofen, paracetamol, acetaminophen, naproxen, codeine

 

"Do I have to be consistant with when I take them / how much I take in the same way I would with an antidepressant to avoid further destabilisation?"

 

Alto's post #2 in the above link.  My thought is that you would take them as needed.

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Elexis

Thanks, so from what I saw on the thread I only really need to be cautious if I'm taking more 'heavy duty' painkillers like codeine, stuff like aspirin / paracetemol / ibuprofen should be fine?

 

Only trouble is that I've been taking ibuprofen for waay longer than I should... think it's meant to be 10 days max... I've taken two tablets a night, every night, for 4-6 weeks. I'd like to stop as I know I shouldn't be doing this, just wondering is it safe to just stop cold-turkey or should I wean myself off?

 

Thanks :)

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Elexis

Thanks for the link, I'll have a good read :)

 

Yeah I think I'll taper to be on the safe side... maybe just drop to 1 ibuprofen a night for a couple of weeks and then stop completely.

 

By the way, my reinstatement is going well, I've been keeping a detailed symptom diary and although there are unpleasant flares from time to time they're short lived, I was surprised at the amount of time I now have with minimal symptoms (around a 4 usually). So nice to know things are improving :)

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AliG

That's great news , Elexis .  :)  I hope things continue to improve for you. 

Ali

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scallywag

What wonderful news that your symptoms have improved that much!  Have we made another convert to tracking symptoms? ;)

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downtongirl

Glad your reinstatement worked for you.

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Elexis

Thanks guys :) and yes, Scallywag, consider me converted - I would never have realised how short my periods of flare-ups actually are if I didn't have a record of it, always feels like it's going on forever at the time!

 

A bit of a problem has happened. :( I've been very stupid and allowed myself to run out of some of my amitriptyline tablets. I normally take a 10mg tablet + a 50mg tablet each night (so total dose of 60mg). I still have enough 50mg ones to last until I can get my prescription but I'm out of my 10mg ones. I've had to miss taking them tonight and will have to miss it tomorrow night as well. Should I be worried? Don't know if I can persuade the doctors to do my prescription any quicker but could try if this could be a serious issue and mess up my reinstatement.

Also, when I do get my hands on the 10mg ones again should I go back to taking them having missed a couple of doses?

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scallywag

Elexis, try and get the 10 mg tablets. You should be able get them within a week of your last dose, just return to 60 mg.

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Elexis

I'll be able to get them tomorrow (so 2 days after my last dose).... I could try and insist on getting them today if you think it'd be urgent?

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Elexis

Update - just got off the phone to the doctor and they're getting me my tablets today :) so will only have missed one dose. What a relief!

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Hopefull

Hi Elexis,

How are you doing? Are you still experiencing PGAD symptoms?

I had PGAD symptoms and it has gone away.

It might take a while for things to settle down.

While I was going through it, I found swimming in the sea very helpful. It stopped PGAD symptoms.

I also found cold sit baths with table spoon of salt helped calm things down.

To this day, even after seeing a so called "drug expert ", no one has been able to explain why SSRI's cause this kind of reaction.

It seems more and more people are reporting this horrible symptom on SA.

You will heal but it does take time.

Best wishes, Hopefull.

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Elexis

Hi  Hopefull,

 

Apologies for such a slow  response, I haven't been on here for a while.

Overall I've been doing well, I've had long periods with no or minimal symptoms, not entirely gone though. I've fallen out of the habit of keeping symptom diaries (silly me) so I can't be sure just how much symptoms I'm having.

Thanks so much for sharing your experience and tips, it's so encouraging to hear of anyone recovering from this symptom :) It can feel so hopeless at times. I'll give the baths a try some time! I'd love to try swimming in the sea but I'm in Scotland so I'd probably die of hypothermia lol

 

Feel a bit awkward saying this but I've noticed  that just about the only time I get severe and prolonged symptoms now is after sexual contact. I wonder, should I tell my partner to basically leave me alone until I'm over this? Seems a bit extreme and I doubt he'd be very happy but I'd hate to do  something to prevent healing... Currently going through a bad flare, symptoms away back up at an 8 and have been for days  :(

 

Going to start keeping my symptom diaries again so I can get a clearer idea of what's going on.

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scallywag

Nice to see your post, Elexis.  I'm glad you've had long windows!

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Elexis

Yeah I've been loving the long windows without symptoms! Really helps keep you motivated to keep going battling through the withdrawal process  :)

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Hopefull

Hi Elixis,

 

It will only get better from now on.

You will heal and be your self again.

Take care, Best wishes, Hopefull. :)

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Elexis

Just posting all my symptom diaries... I find it helpful storing them on this thread - no risk of me losing them!

 

30th August

2pm: 0

4pm: 4

6pm: 2

7pm: 6

9pm: 2

11pm: 7

1am: 2

 

31st August

2pm: 0

4pm: 4

6pm: 6

8pm: 3

10pm: 6

11pm: 2

 

1st September

2pm: 0

3pm: 4

6pm: 6

8pm: 4

9pm: 6

12am: 3

 

2nd September

2pm: 0

3pm: 4

6pm: 6

7.30pm: 3

8pm: 6

9pm: 4

10.30pm: 6

11pm: 4

1am: 2

(Brief spike to 8 during the night)

 

3rd September

2pm: 2

4pm: 6

8pm: 8 (after sitting for 6  hours!)

9pm: 5

 

On 5th September missed 10mg dose of Amitriptyline. Resumed on 6th September.

 

7th September

2pm: 0

3pm: 5

4pm: 7

6pm: 8

8pm: 6

12am: 5

 

8th September

2pm: 2

3pm: 7

5pm: 8

Used ice-pack at 8pm.

9pm: 6

10pm: 5

10.30: 6

12am: 5

 

9th September

2pm: 2

3pm: 5

5pm: 3

Stayed at 3-4 all night.

 

10th September

3pm: 0

4pm: 6

5pm: 7 - then used icepack

6pm: 4

7pm: 2

9pm: 3

 

11th September

8am: 5

2pm: 3

4pm: 2

7pm: 4

 

------

 

Flare up on 20th October. Started keeping symptom diary again.

 

23rd October

4pm: 6

5pm: 3

7pm: 6

10pm: 7

12am: 4

 

24th October

1pm: 7

5pm: 3

1am: 4

 

25th October

10am: 4

11am: 5

1pm: 7

3pm: 4

6pm: 6

12am: 4

 

26th October

1pm: 4

6pm: 5

1am: 6 (ice pack)

 

27th October

2pm: 3

3pm: 5

6pm: 3

9pm: 5

1am: 6

5am: 7 (ice pack)

 

28th October

2pm: 5

4pm: 7

7pm: 7

9pm: 4

1am: 3

 

29th October

1pm: 3

6pm: 7

9pm: 4

 

30th October

1pm: 2

2pm: 3

6pm: 2

9pm: 5

4am: 6

 

1st November

8am: 6

9am: 8

2pm: 6

4pm: 4

9pm: 2

 

4th November

1pm: 2

6pm: 4

8pm: 7

12am: 6

 

5th November

1pm: 6

5pm: 4

8pm: 6

10pm: 5

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Elexis

Hi folks,

just a quick question, I couldn't find the answer when searching.

I used to take Nytol tablets when I couldn't sleep, they're sleeping tablets with the antihistamine Diphenhydramine Hydrochloride.

 

Is it safe to still take these  occasionally if I'm still  going through my Prozac withdrawl? I haven't taken any since these withdrawl symptoms started as I worried about making my symptoms worse...

 

Thanks

x

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Elexis

Thanks for the info, had a read and I think I'll give the antihistamines a miss.

 

Unfortunately turns out I've been a bit silly and while not taking antihistamines for sleep I've been taking a herbal supplement thinking it would be harmless. Been taking it for 2-3 months (which is way too long for starters), it contains Valerian, Hops Strobile and PassionFlower. I've just read the thread on here about Valerian and it sounds like it affects CNS so I really want to get off this stuff now.

 

I take 2 tablets a night, so 60mg of Valerian. One of the reports posted on the thread recommended gradual withdrawal over 1-2 weeks - does that sound too fast? I'm wary as I've seen reports on medical websites saying you can withdraw from Prozac over 3-4 weeks and y'know how well that worked out for me!

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Altostrata

If the herbal supplement helps you sleep with no other side effects, no need to stop.

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Elexis

Tbh I'm not convinced it's really helping my sleep anymore. It did at the start but I've been taking it more out of habit than anything  else lately.

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AliG

If you are convinced the Valerian is not helping you sleep and you want to discontinue it, I would taper off very gradually over a period of months just to be cautious and avoid any problems.

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Elexis

Okay, would that involve tapering at 10% per month like with coming off antidepressants, or do we go a bit quicker since it's a herbal supplement? I'm on 60mg, which seems to be a relatively small dose.

 

If you think it could be risky to come off these while still dealing with withdrawal from Prozac I don't mind staying on them, just worried the longer I stay on the harder it will be to stop? there seems to be some evidence for valerian being potentially addictive.

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